Key result
A community health promotion initiative significantly reduced hypertension prevalence in women from 24.7% to 16.1% (PR 0.65) and lowered mean fasting plasma glucose and total cholesterol levels.
Why the study?
The study evaluated the effectiveness of a 2015-17 community health promotion intervention to reduce CVD and T2DM risk factors in an adult Sri Lankan population.
Does a community health promotion intervention reduce cardiovascular disease and type 2 diabetes risk factors in a Sri Lankan adult population?
Cross-Sectional (n=1,903)
Yes
Does a community health promotion intervention reduce cardiovascular disease and type 2 diabetes risk factors in a Sri Lankan adult population?
Relative Risk: 0.65 (95% CI 0.51–0.84)
Absolute Event Rate: 16.1% vs 24.7%
Absolute Risk Reduction: 8.6%
p-value: p=<0.0001
A community-based health promotion intervention utilizing primary healthcare networks and local change agents significantly reduced population-level blood pressure, fasting glucose, and cholesterol in Sri Lanka.
Community interventions may lower CVD risks in low-resource settings; leaves open causality and durability pending prospective trials.
BACKGROUND: The effectiveness of a 2015-17 community intervention to reduce cardiovascular disease (CVD) and type 2 diabetes (T2DM) risk factors is assessed in a Sri Lanka adult population, using a before-and-after study design. METHODS: Four contiguous Public Health Midwife (PHM) areas in Kalutara district (Western Province) were exposed to a Sri Lankan designed community health promotion initiatives (without screening) to lower CVD and T2DM risk factors. Pre- and post-intervention surveys (2014, n=1,019; 2017, n=908) were of 25-64 year males (M) and females (F) from dissimilar randomly selected clusters (villages or settlements) from PHMs, with probability of selection proportional to population size, followed by household sampling, then individual selection to yield equal-probability samples. Differences in resting blood pressure (BP), fasting plasma glucose (FPG), total cholesterol, body mass index and tobacco smoking, adjusting for cluster sampling, age and socio-economic differences, were examined. RESULTS: Hypertension prevalence declined from 25% to 16% (F) (p<.0001), and 21% to 17% (M). Both mean systolic and diastolic BP declined. T2DM declined from 18% to 13% (F), and 18% to 15% (M), as did mean fasting plasma glucose. Elevated total cholesterol declined from 21% to 15% in women (p=0.003) and mean cholesterol declined. Frequency distributions, medians and means of these continuous CVD risk factors shifted to lower levels, and were mostly statistically significant (p< 0.05). CONCLUSIONS: Community health promotion can lower key CVD and T2DM risk factors. Lowering tobacco consumption in males and obesity remain challenges in Sri Lanka.
No takes yet. Share an insight, caveat, or question.
Gamlath et al. (2020) conducted a cross-sectional in Cardiovascular disease risk factors (n=1,903). Community health promotion initiative vs. Pre-intervention baseline was evaluated on Hypertension prevalence in women (PR 0.65, 95% CI 0.51-0.84, p=<0.0001). A community health promotion initiative significantly reduced hypertension prevalence in women from 24.7% to 16.1% (PR 0.65) and lowered mean fasting plasma glucose and total cholesterol levels.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: